1. Collateral Circulation and Outcome in Atherosclerotic Versus Cardioembolic Cerebral Large Vessel Occlusion
- Author
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Guglielmi, V., LeCouffe, N.E., Zinkstok, S.M., Compagne, K.C.J., Eker, R., Treurniet, K.M., Tolhuisen, M.L., Worp, H.B. van der, Jansen, I.G.H., Oostenbrugge, R.J. van, Marquering, H.A., Dippel, D.W.J., Emmer, B.J., Majoie, C.B.L.M., Roos, Y.B.W.E.M., Coutinho, J.M., Lugt, A. van der, Zwam, W.H. van, Boiten, J., Vos, J.A., Mulder, M.J.H.L., Goldhoorn, R.J.B., Kappelhof, M., Schonewille, W.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Roozenbeek, B., Bruijn, S.F. de, Dijk, L.C. van, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J., Doormaal, P.J. van, Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Tolhuijsen, M.L., Alves, H., MR-CLEAN Registry Investigators, Neurology, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Radiology & Nuclear Medicine, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Graduate School, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, AGEM - Re-generation and cancer of the digestive system, AGEM - Digestive immunity, CCA - Imaging and biomarkers, ARD - Amsterdam Reproduction and Development, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, RS: CARIM - R3.11 - Imaging, Promovendi CD, MUMC+: MA AIOS Neurologie (9), MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), and MUMC+: MA Niet Med Staf Neurologie (9)
- Subjects
Carotid Artery Diseases ,Male ,endovascular treatment ,Original Contributions ,FEATURES ,EMBOLIC STROKES ,Brain Ischemia ,Modified Rankin Scale ,Occlusion ,Medicine ,Advanced and Specialised Nursing ,Registries ,collateral circulation ,ACUTE ISCHEMIC-STROKE ,Stroke ,HYPOPERFUSION ,Aged, 80 and over ,education.field_of_study ,Brain ,Atrial fibrillation ,Middle Aged ,THROMBECTOMY ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Collateral circulation ,ETIOLOGY ,Intracranial Embolism ,Cardiology ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,Internal carotid artery ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,atherothrombotic stroke ,Population ,Clinical Sciences ,Clinical Neurology ,UNDETERMINED SOURCE ,CLASSIFICATION ,All institutes and research themes of the Radboud University Medical Center ,medicine.artery ,Internal medicine ,ischemic stroke ,Humans ,cardiovascular diseases ,education ,cardiac emboli ,Aged ,Advanced and Specialized Nursing ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,medicine.disease ,CT ANGIOGRAPHY ,Stenosis ,ATRIAL-FIBRILLATION ,Neurology (clinical) ,business - Abstract
Supplemental Digital Content is available in the text., Background and Purpose— Due to chronic hypoperfusion, cervical atherosclerosis may promote cerebral collateral circulation. We hypothesized that patients with ischemic stroke due to cervical carotid atherosclerosis have a more extensive collateral circulation and better outcomes than patients with cardioembolism. We tested this hypothesis in a population of patients who underwent endovascular treatment for large vessel occlusion. Methods— From the MR-CLEAN Registry (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), we selected consecutive adult endovascular treatment patients (March 2014 to June 2016) with acute ischemic stroke due to anterior circulation large vessel occlusion and compared patients with cervical carotid artery stenosis >50% to those with cardioembolic etiology. The primary outcome was collateral score, graded on a 4-point scale. Secondary outcomes included the modified Rankin Scale (mRS) score and mortality at 90 days. We performed multivariable regression analyses and adjusted for potential confounders. Results— Of 1627 patients in the Registry, 190 patients with cervical carotid atherosclerosis and 476 with cardioembolism were included. Patients with cervical carotid atherosclerosis were younger (median 69 versus 76 years, P
- Published
- 2019